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- 저자 : ( Kyung-suk Suh Surgery ) (검색결과 1 건)
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( Kwang-woong Lee ),( Suk-won Suh ),( Jaehong Jeong ),( Hyeyoung Kim ),( Nam-joon Yi ),( Kyung-suk Suh Surgery ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: In spite of expansion of indication for advanced hepatocellular carcinoma (HCC), the portal vein tumor thrombosis (PVTT) has been accepted as an absolute contraindication for liver transplantation. However, we experienced unexpectedly good prognosis in selected cases with pre-transplant PVTT. In this study, we tried to identify the prognostic factors after living donor liver transplantation (LDLT) for HCC with major PVTT. Methods: Between January 2009 and December 2013, 282 patients underwent living donor LT (LDLT) for HCC at our institution. Among them, 11 patients (3.9%) with major PVTT diagnosed before transplantation were retrospectively reviewed. Results: The duration of follow-up was more than 2 years in all patients. HCC recurrence occurred in 6 patients (54.5%) after LDLT. One-year, 3-year, and 5-year recurrence-free survival was 63.6%, 42.4%, and 42.4%, respectively. One-year, 3-year, and 5-year overall survival was 72.7%, 63.6%, and 63.6%, respectively. Main PV invasion, high value of multiplication of AFP and PIVKA-II (AP score, ≥ 20,000), large original tumor (> 7cm) were significant risk factors for HCC recurrence after LDLT in pre-transplant major PVTT. There was no recurrence in 5 patients with low AP score (< 2,000). Conclusions: If pre-transplant PVTT is not to exceed main PV and AP score is less than 20,000, we can consider LDLT as a curative treatment option. [figure1]
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